87TH MEDICAL GROUP (NPI# 1346347192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346347192 |
| Entity Type | Organization |
| Organization Name | 87TH MEDICAL GROUP |
| Other Organization Name | MCGUIRE PHCY |
| Practice Address |
3458 Neely Rd Joint Base Mdl NJ 08641-5312 |
| Mailing Address |
87th Medical Group C/o Resource Management Office 3548 Neely Rd Joint Base Mdl NJ 08641 |
| Practice Telephone | 6097549465 |
| Mailing Telephone | 6097549464 |
| Mailing Fax Number | 6097549133 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-02-09 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2054338 | 01 |
| Other Name | Type Code |
|---|---|
| MCGUIRE PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255430609 | 87th Medical Group | Military/U.S. Coast Guard Pharmacy | Naval Weapon Station Earl Hwy 35, Leonardo, NJ 07737 | 2006-09-22 |
| 1427465889 | 87th Medical Group | Pharmacy | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2014-07-17 |
| Street Address |
3458 NEELY RD |
| City | JOINT BASE MDL |
| State | NJ |
| Zip Code | 08641-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649276866 | Patrick Anthony Johnson | Optometrist | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2005-06-22 |
| 1770068942 | Oliver Moore | Nurse Practitioner | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2018-10-03 |
| 1356848758 | Jeffrey Chung Hee Kim | Pharmacist | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2018-04-11 |
| 1881192284 | Sara Anne Keith | Social Worker | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2018-01-31 |
| 1861920787 | Sion Kim | General Practice | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2017-05-24 |
| 1427465889 | 87th Medical Group | Pharmacy | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2014-07-17 |
| 1710304852 | James Miller | Psychologist | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2014-03-26 |
| 1538408646 | Elle Sowa Cleaves | General Practice | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2013-02-08 |
| 1710221676 | Stephanie Ricks | Nurse Practitioner | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2012-11-15 |
| 1689935165 | Kathleen Erin Hemphill | Pharmacist | 3458 Neely Rd, Joint Base Mdl, NJ 08641-5312 | 2012-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497108856 | Prince Philip | Internal Medicine | Jbmdl, 3458 Neely Road, Apo, AA 08641 | 2016-07-20 |
| 1932517851 | Brittany Russell | Counselor | 3458 Neeley Rd, Jb Mcguire-dix-lakehurst, Wrightstown, NJ 08641 | 2014-07-23 |
| 1306263108 | Jamal Hogan Sr. | Military Health Care Provider | 3322 Charles Blvd, 108th Crg, Mcguire Afb, NJ 08641 | 2014-03-19 |
| 1659505030 | Kimberley Dawn Bock Tabor | Military Health Care Provider | 3453 Neely Rd, Mcguire Afb, NJ 08641 | 2009-05-13 |
| 1780835686 | Jeffrey Matthew Butch | Nurse Practitioner | 87th Medical Group, 3458 Neely Road, Jbmdl, NJ 08641 | 2008-10-09 |
| 1376736041 | Jennifer Bench | Dental Hygienist | 305th Dental Squadron, Bldg. 2417 Mcguire Blvd., Mcguire Afb, NJ 08641 | 2007-08-24 |
| 1447383765 | Nikolay Sky | Dentist | Mcguire Air Force Base, New Hanover, NJ 08641 | 2007-03-14 |
| 1003995085 | Kevin Hale Black | Dentist | 205th Dental Squadron, Bldg 2417, Mcguire Blvd, Mcguire Afb, NJ 08641 | 2006-11-02 |
| 1336234285 | Barbara D Broadt | Dietitian, Registered | 305 Medical Group 3458 Neely Road, Mcguire Afb, NJ 08641 | 2006-10-04 |
| 1649378043 | Judith Anne Frankel | Psychologist | 3458 Neely Rd., 305th Medical Group/sgomh, Mcguire Afb, NJ 08641 | 2006-09-20 |
| Find all providers in zip 08641 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710287198 | Lakehurst | Military/U.S. Coast Guard Pharmacy | 39 Lansdown Road Bldg 39, Naval Air Engineering Station, Lakehurst, NJ 08733 | 2010-11-01 |
| 1104011667 | Atlantic City Uscg Phcy | Military/U.S. Coast Guard Pharmacy | Amelia Earhart Road, Bldg 350, Atlantic City, NJ 08405-0001 | 2007-09-07 |
| 1346349792 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | Bmc Bldg 39, Naval Engineering Station, Lakehurst, NJ 08733 | 2006-09-22 |
| 1255430609 | 87th Medical Group | Military/U.S. Coast Guard Pharmacy | Naval Weapon Station Earl Hwy 35, Leonardo, NJ 07737 | 2006-09-22 |
| 1528167970 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 18th St and Doughboy Loop Bldg 5660, Troop Medical Health Clinic, Ft Dix, NJ 08640 | 2006-09-22 |
| 1164529913 | Us Coast Guard Finance Center | Military/U.S. Coast Guard Pharmacy | 1 Munro Ave Bldg 270, Cape May, NJ 08204-5000 | 2006-09-20 |
| 1255438008 | Colts Neck Phcy | Military/U.S. Coast Guard Pharmacy | 201 State Route 34 S Bldg C3, Naval Weapons Station Earle, Colts Neck, NJ 07722-1902 | 2006-09-20 |
| 1518150598 | Green Valley Medical Equipment | Military/U.S. Coast Guard Pharmacy | 214 E Main St, Bound Brook, NJ 08805-2026 | 2007-08-22 |
| 1194889865 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1075 Stephenson Ave, Monmouth Poe Phcy, Fort Monmouth, NJ 07703-1518 | 2006-12-20 |
| 1437258886 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1075 Stephenson Ave, Bldg 1075 Monmouth Op Phcy, Fort Monmouth, NJ 07703-1518 | 2006-09-22 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE MDL |
| Zip Code | 08641 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.